Re: E Vitamin and Thalassemia unaffected carriers

<Nobody told me it's dangerous. I simply read that Vitamin E is a blood

<thinner. Since the unaffected carriers of thalassemia (microcytemia)
<have smaller and irregular shaped red blood cells (and much more red
<blood cells than normal people), I'm wondering whether it could
<undesired effects or not.

You really didn't say what type of thalassemia you had and I assume you
have a silent carrier alpha/alpha alpha/ - single gene deletion alpha

You are asymptomatic and not anemic with an alpha beta ration of 0.8 to
0.9 which is very mild in comparison to normal 1:1.

Apart from the microcytosis, erythrocytosis and target cells, one has
inclusions of heinz bodies. Oxidative stress can increase heinz body
production and so vitamin E is an antioxidant being used in thalassemia
trait and disease the more severe forms to protect the red cells. You
also have iron problems in the anemia proper patients that contribute
to the stress.

Thalassemia, sickle cell disease and hemoglobinapthies and G-6 PD are
genetically selected for malarial resistance and can have concordance.
There is a higher than normal incidence of G-6 PD deficiency in these
groups. This enzyme system is responsible for protecting the red cell
from oxidative stress and destruction and when deficient then one is
subjected to oxidative stress.

Blood thinning properties are usual in and over 1000 IU vitamin E a day
range. I am unaware of any bleeding tendencies in thalassemia. If it is
present then another source for that needs to be looked into.

1: J Med Assoc Thai. 2005 Sep;88 Suppl 4:S317-21. Related Articles,
Books, LinkOut

The benefits of vitamin C and vitamin E in children with
beta-thalassemia with high oxidative stress.

Dissayabutra T, Tosukhowong P, Seksan P.

Department of Biochemistry, Faculty of Medicine, Chulalongkorn
University, Bangkok, Thailand.

The present study aimed to determine the benefits of vitamin C and
vitamin E as antioxidant supplements in beta-Thalassemia children who
are at risk of iron overload due to multiple blood transfusion and high
oxidative stress. Antioxidant status, oxidative products, plasma free
hemoglobin, total hemoglobin and bilirubin were discussed. Twenty
children who had laboratory confirmation of major beta-Thalassemia at
least 6 months with history of packed red cell transfusion without iron
chelation were recruited. The informed consent for blood sample
collection and antioxidant medication was performed. Most patients
(85%) had hyperferritinemia and all of them had high oxidative stress.
All of them had low vitamin C and vitamin E level at recruitment. Three
months after vitamin C and vitamin E supplementation, plasma vitamin C,
vitamin E and glutathione were significantly increased, while total
bilirubin was slightly decreased without significance. Other parameters
included total antioxidant status (TAS), plasma and erythrocyte
malondialdehyde (MDA), hemoglobin and plasma free hemoglobin had no
differences during the study period. CONCLUSION: B-Thalassemia major
children who had multiple blood transfusion are at risk in iron
overload and high oxidative stress. From the present study, no
significant improvement in raising hemoglobin and concerning low dose
vitamin C is not contraindication in beta-Thalassemia patients.
Therefore, vitamin C plus vitamin E supplementation have benefits more
than vitamin E alone in promoting antioxidant status and may enhance
liver function as total bilirubin tends to decrease.

PMID: 16623048 [PubMed - in process]

1: Indian Pediatr. 2005 Nov;42(11):1141-5. Related Articles, Books,

Antioxidant status in children with homozygous thalassemia.

Dhawan V, Kumar KhR, Marwaha RK, Ganguly NK.

Department of Experimental Medicine, Postgraduate Institute of Medical
Education and Research, Chandigarh 160 012, India.

The status of enzymatic and non-enzymatic anti-oxidants was evaluated
in 41 patients with transfusion dependent beta-thalassemia. An
additional 20 age-matched children, with non-hemolytic anemia, served
as controls. Fresh blood samples, obtained in the morning, were
processed immediately. Plasma was stored at -80 degrees C. Levels of
vitamins A and E were assayed simultaneously by HPLC. RBC vitamin A was
not measurable in 29 (70.7%) thalassemics and in all the controls.
Plasma vitamin A levels were lower in thalassemics than in controls
(p<0.05). Vitamin E in RBCs was not measurable in 13 (31. 7%) cases.
The mean level of RBC vitamin E was 3 times lower in thalassemics.
Similarly, SOD enzyme activity in thalassemics, was at least 1.5 lower
in comparison to the activity documented in controls (p<0. 05). The
observations indicate that thalassemics have enhanced oxidative stress.
Administration of selective antioxidants and a balanced diet may
preclude oxidative damage.

PMID: 16340055 [PubMed - indexed for MEDLINE]